Something a Little Different

A few months ago, following my most recent HuffPost article I was contacted by a fellow nurse blogger to be featured in a segment she does about nurses around the country. Eileen is a nurse now living in San Francisco and focusing her energy on teaching, speaking, and coaching. She leads seminars and maintains a blog focusing on meditation, mindfulness, and the hardest of all; balance.
I took the opportunity to answer her questions. I felt like a learned a lot about myself trying to think through my answers. Furthermore, as I considered balance and my need for it, I realized that I am finally in a place where I feel like I am figuring it out.
The good news is that it has left me more relaxed, rejuvenated, and rewarded in my personal life. The bad news is that I have not felt as obligated to write, which was nice at first, but as the whirlwind job transition, holiday season, and big personal events of recent months come to a close, I am finding myself missing it. I promise to be back to you soon.
But in the meantime, please take a moment to check out Eileen’s blog. I have included the link to my interview here.
If you have questions of your own you would like me to answer, do not hesitate to leave them in the comment section! I would love to answer them for you!

Until then, keep calm and balance on!

A Thursday Throwback

I just opened my email to kind and unexpected “Happy Anniversary” from the site I use for my blog.

Two years. Today marks two years that I have been writing and you have been reading. But in reality, many of you met me long after this blog was created and far from it’s original intention. So I thought to myself, why not introduce you to how it all began, and in doing so, remind myself of why this all started. I am back to a diet full of gluten, I have forgotten the drive to prioritize my health, but below is an excerpt from my original post here on According to Kateri. With a little work and this nice reminder, I can work to get back there. Thank you to those of you who have followed me from the beginning, and welcome to those of you who have joined me along the way.

My Body is a Temple

As a child raised in a religiously involved Christian family I was groomed on the concept that my body is a Temple; something sacred and special, something to be cared for, respected, and guarded. As an adolescent working hard every day at the chance for a future as a ballerina, I was taught that my body is a tool. Something I can mold and train to do what I want and need it to do, something I am ruler over. Yet, in contrast, as a woman in this day in age, specifically a woman with Crohn’s disease, I have somehow fallen into the belief that my body is my enemy. It is sick when I wish to be well. It is big when I wish it to be small, straight when I wish it to be curved.

I have spent years making plans and cancelling them due to illness, fatigue, or pain. I have missed school, missed work, and missed life. At times my body is consumed by my disease and every decision is based on what my body needs. Yet, even with all of the right decisions, at times my body still gets worse, feels worse. Through multiple flare ups and surgeries since the age of 13 I have decided my body is against me, I am its enemy and it is mine. It is hard not to feel this way, considering the disease itself is my body attacking me…

In periods of health, between flares, the woman inside of me takes over. My body remains my enemy for not looking like a model, not having a perfectly flat stomach, toned legs, perfect butt. In both cases food is my Kryptonite, the ultimate weakness that inevitably destroys me. Fueling my body is a challenge of the wills, calories versus carbs versus fat versus what it will do to my belly. An embarrassing amount of the day is focused on controlling the evil food that fuels my enemy body.

During my dancing days.

During my dancing days.

This needs to change.

I have always had a reactive response to my body: it gains weight, I lose it, it flares up, I make changes. In the health care world, where I spend my professional time, we have finally realized a reactive medical system, while necessary at times, especially with acute illness, is not enough to maintain the highest level of health. Being proactive is ultimately the best way to go. Making changes based on what will be best before the worst case occurs.

I have decided to start treating my body this way. I made a massive diet change last June in the midst of a Crohn’s flare and eliminated gluten from my diet. At first it seemed like a nightmare, like more than I could or wanted to deal with, but now, six months later, its simply the way I eat. To be honest, I am aware on a daily basis how much better I feel for it. In that same way it is time for me to change how I view and treat my body. I am turning it into a temple and tool again.

So if my body is in fact a temple, it is time I view and treat it as such. Make it a priority. Everything I do to it or put into it matters. I am going to remain gluten free and mostly organic as I have been, but I am hoping to learn to shift my focus from food as evil to food as fuel. In the past food has been what makes me sick, is often off limits, and then often over appreciated when periods of liquid diets and other restrictions end. Food is however what makes our cells reproduce, what turns fat to muscle, gives our brain the sugar it needs to think and move our bodies.

It is time that I see it and consume it that way. And as for my body, I am going to make it a tool again, mold and train it to be the best it can be. Improve its strength and flexibility, teach it to relax when it needs to. I am going to take my health into my own control, rather than spending my days feeling controlled by my currents state of health, or lack there of.

Perhaps if my body is no longer my enemy, I will no longer be it’s, we can live together, a happier, stronger, and more fulfilled life. So here it goes…

Becoming Her

Over a recent vacation in my childhood home, I spent some time sorting boxes that have accumulated over the years. I triaged their contents for their importance in my life. Each box had been in a storage unit until recently, now they filled what was once my brother’s wood shop. Box after box of extra pots and pans, Christmas decorations, shoes, and serving platters. To keep or not to keep, that was the question.

In a box I came across an empty notebook, the pretty kind that you give as a gift when you cannot think of anything else to give, and have ruled out fancy soap. I flipped through it quickly, finding page after page of empty lined paper. I set it aside in the pile of items to donate.

“Do you need this?” my mom asked a few minutes later, the notebook in hand, open to a page I must have missed, full of my scratchy writing.

I took it from her, glancing closer to find my answers to an interview for the local newspaper upon my graduation from high school.

Something your classmates would say is out of character for you: Counting calories.

Where do you see yourself in 10 years: Starting a family and loving the woman I have become.

Advice for your fellow classmates: Avoid apathy.

I thought back to my 18year old self, the world she saw and knew. Then I thought about me today, the 10 years later Kateri.

Society spends so much time talking about the advice we would give our younger selves if we had the opportunity, but I couldn’t help but wonder the opposite.

Given the chance to meet me today, how would that younger version of me feel?

Would she be proud of the woman I am today?
Have I avoided apathy?
Have I lived up to her expectations?

What about you? Think back to yourself at the height of your naivety, the peak of your idealist, clueless, dreamer self. Have you lived up to the person you planned to be? Sure, the world gets in the way, life gets hard, and you find all of these roadblocks you never knew existed along the way. But it isn’t too late to find ways through them and around them. It isn’t too late to slow down and redirect your focus to finding that person you wanted to be.

At 18, unlike many of my classmates and friends, I didn’t have a list of accomplishments I planned to achieve. Rather, I envisioned a person I wanted to be. I can’t help but accept that somewhere along the way, during the past decade, it stopped being about her and started being about what she has done, will do, can do. And of course all of that is wonderful. But,

For today, and maybe tomorrow too, I am going to take a minute and see if I can’t become more of the girl she wanted me to be. One who doesn’t count calories, one who loves the woman she is, and one who above all else, avoids apathy.

What I’ve Learned About Love

While I work on my next post to share with you all here, I wanted to show you something else I have been working on. Below is a link to an article I wrote for the Huffington Post, sponsored by Johnson & Johnson’s Love Matters campaign. Please check it out and let me know what you think! There are other amazing articles on the same page.

As always, more to come soon!

Wash Your Finger Pointing Hands

Ebola is upon us, its official, because everyone is officially freaking out.

On the one hand, it is no surprise that a nurse was the first to contract the virus here on American soil given the hands on, prolonged contact, fluid ridden role we play in health care. Globally, nurses have been on the front lines of this virus for months, often the first infected. In fact, in Liberia, the astounding number of nurses who fell ill resulted in a large impact of the ability to treat and maintain the illness in the cities of a country whose health care system is so much less secure than our own. Imagine the staffing grids over there right now!

But I digress. My point is, that it is no surprise that one of our own was the first to test positive in America. But I have to admit; my initial response was one of dejected disappointment. This feeling was only increased as story after story flooded my news feed and twitter account of the need to identify the “breach in protocol” that caused her to contract the potentially deadly virus. Story after story, person after person, made it sounds more and more like a search for her mistake. I was angry that she was being blamed. I was sad for her that she was sick and also for the position she has been placed in, thrust into the spotlight of fearful masses and frustrated health care professionals. I was sad for nurses.

And then two things happened. First, physicians apparently spoke out in her defense, scolding the CDC for publicly shaming her through their outspoken investigation into the “breach” that occurred. You see, to those of us in health care, this investigation is routine. Each of our mistakes and near misses are examined in the same way. Not with a goal to shame the professional, but to improve the system. What the articles failed to mention was that these occurrences are normal. There is no doubt that an investigation is necessary, but fearful masses can’t hear that sort of rational statement without making it something it isn’t. The first response to fear is often a search to find a source for blame. So thank you, to the physicians who spoke out against the CDC’s (I hope) inadvertent statements of mistakes and subsequent blame rather than their goal to improve policy and procedure.

The second thing was a friend’s statement yesterday, about how often we are faced with the choice to don our PPE or save our patient. That the focus should have been on her willingness to put herself at risk, the unfortunate result being her own illness rather than that of a mistake, of her responsibility of putting herself, maybe even others in jeopardy. (Thanks Beth, you’re awesome). How often have you run into a room for emergent suctioning, or God forbid chest compressions, the mask in your hand instead of fully onto your face until you’re part way into the room? Don’t get me wrong, the stakes here, with a virus like Ebola are higher, and we will respond accordingly when it comes to safety and PPE. But the reality is that PPE isn’t perfect, somewhere between application and removal, prolonged contact in a room, emergent needs, etc., mistakes can happen, mistakes will happen.

The most important thing I realized in what my friend Beth said was this, we are in this together. And we need to start acting that way. So instead of sharing your fears, educate yourself about the real facts of the virus. Instead of standing by while people talk about what she may have done wrong, support her. Thank the nurses you work with for continually putting their health at risk for their patient’s, for the fact that they will continue to do so. Stop sharing articles on your social media accounts from uneducated, unreliable sources. Don’t perpetuate the fear everyone is feeling. If you’re looking for someone to blame, take your pointed finger down and wash it. Then wash it again.

And as you’re doing that, send some get-well wishes to a bad a** nurse we should all start looking up to. Because if an Ebola patient rolls into your unit tomorrow, will you be volunteering to have them in your assignment?

Get well soon Nina Pham. You sure aren’t Just a Nurse.

I do not mean to minimize the severity of this illness, and certainly do not intend to imply that hand hygiene would prevent this illnesses spread. However, I stand firm in my opinion that accelerating the hype is more damaging than productive, especially when it comes from members to the health care system.

Lessons from a Year as Just a Nurse

I learned a lot in Kindergarten, but unfortunately, and contrary to popular belief, I didn’t learn everything. It felt like I learned a lot in nursing school, but it still wasn’t enough. I have learned a lot in nursing, in my years thus far of being a nurse at the bedside. But most of all, I have learned exponentially more than I would have imagined in a year of open dialogue with nurses; from nursing students to seasoned nurses. Burnt-out nurses to those still full of naïve passion. These are some of the most valuable lessons I learned and applied in the past year.

Don’t cry over spilled…

Poop. They say don’t cry over spilled milk, but I have worked in NICUs and PICUs and I can tell you that a drop, an ounce, a whole frozen milksicle of hard earned maternal breast milk is certainly worth crying over. I’ve learned to grip that stuff like the world’s last Faberge Egg, heart racing at the very thought of it slipping from my hands to the floor. The perfect details of someone’s handiwork shattering around my Dansko clogs, the whole world in that instant painfully and resentfully aware of the negligent mistake I have made.

The explosive diarrhea that gets on your glove and through a misguided, poorly thought-out, quick swipe of those flyaway hairs out of your face, gets firmly planted on the edge of your curls, causing you to drop the bed pan, splattering it all over the floor, your shoes, pants, the IV pole, and wall with a loud crash that brings even the laziest of coworkers running in your direction. That isn’t worth a single tear, unless it is from an over abundance of laughter hours later over an aptly chosen mudslide at the bar around the corner with your coworkers when the shift is over.

I have learned that my day often, if not consistently, does not go as planned. It isn’t worth my tears though, or even my disappointment. Learning to go with the flow has been a valuable lesson that has come closer and closer to home in the larger and busier units I have worked on. More so, watching the nurses who have burnt out early versus those with impressive staying power seems to be highly correlated with their ability to let things go without getting bent out of shape over it. So don’t cry over the poop, the sputum, the dilaudid you just dropped on the floor… but never, ever, ever drop the breast milk!

What’s gonna work? Team Work!

This is the chorus of a theme song on a children’s cartoon. Working in pediatrics, it seemed to always be playing in the background in all of the moments when I needed the reminder the most.

How am I ever going to make it through this assignment alone?

I would frantically whisper to myself early in the day.

And in that moment the cartoon gerbils, or munchkins, or whoever they are, would musically remind me of how.

I am never alone.

I can tell you a story, that I sat with a lonely patient on my lap, administering his meds one by one through his central line, IV syringe pump on the bed ahead of me. But I wouldn’t be telling the full story unless I added that Molly brought the medications to me from the refrigerator and locked medication bin, going through the patient’s medical profile and verifying one by one that each medication was correct, giving them to me lined up in order of administration time to ease my work of again verifying each medication against my patient’s profile and then his arm band.

I would also have to tell you that Leigh had come in to remove the IV pump from the pole where it originally stood, leaving the IV line taught, at risk of snapping or coming undone. She detangled the many lines and cords to place them safely on the bed. I would need to mention the resident who checked in frequently, relieving me at one point when after hours of sitting I realized I could not hold my bladder another minute. She moved easily into my spot and he stroked her hair instead while I ran to the bathroom.

And I would have to mention Kathy, the nurse on the night shift who relieved me, agreeing to take my place with the patient in her lap, rocking him to sleep and tucking him into bed for the night.

I have learned that I am never, ever alone. In a code, I have had team members already helping out before I have even found my voice to yell for their assistance. The moment before I have become tired from compressions a resident or other nurse has tapped my shoulder and seamlessly taken over. When my patient has passed, and I have felt the sinking loneliness of failure, I have felt more supported and surrounded as each and every person has checked in, asking if I am ok. The charge nurse has sent me away for a deep breath and cold water on my face, and I have returned to a fellow nurse compiling my notes to ease to overwhelming task of documenting the precipitating events in time to accept my next patient.

Teamwork works, and it is often so natural in this environment that it goes unnoticed.

Rise, and shine, and give… the Glory, Glory

If that line doesn’t start the chorus of the children’s song in your head you must have spent less time in Sunday school than I did. But regardless, I have learned in nursing, and in life, the importance of giving the glory somewhere else.

“I don’t believe in God.”

You may say. To which I reply, not a problem! Just find another source. It could be a coworker, an old professor, or the Christmas cactus in your living room. Regardless, if you focus on the glory of what you do going to someone else you won’t miss it if it isn’t there. When you take the glory for yourself you start to expect it, and when it doesn’t come your way you begin to lose your passion and drive. Those feelings of burn out may start to creep in, or even worse, you may begin to resent the patients, families, physicians, who once glorified the work you do and suddenly do not, or haven’t for some times.

One of the issues I see in nursing, and I am as guilty as any other, is that we don’t feel respected, so as a result we are desperate for recognition. There’s a big difference between wanting recognition for the nursing profession and recognition for your self, as a nurse. Don’t mess with the latter, its risky business and can lead you down a slippery slope.

So find where you will send all of your recognition, the your God, your gods, or your team, it doesn’t matter. What matters instead, is that you learn to not find your worth in what you do based on the praise you receive for it.

Talk to Me

I have been so lucky in the past year to be thrust into dialogue with nurses around the world. I have a learned a lot from all of them, about our differences and similarities, new nurses versus the old the staples. But most of all, I have learned that as much as we like to talk to each other about what we do, we do not succeed in telling the world about it. And when we try, for some mysterious reason, it comes out like a laundry list of complaints and requests from martyrdom.

We aren’t martyrs! We chose this profession, and it is time we start treating it like one. If the desire is for nursing to be seen and respected it is time to use our words and eloquently, confidently, to share what we do with society. Instead of complaining that doctors are portrayed in television, recognize that it is because physicians have written books and screenplays and placed their profession there sooner or more often than nurses have. Instead of crying that nurses are portrayed negatively, watch Wolf of Wall Street, Silence of the Lambs… We aren’t the only ones portrayed negatively by characters or stories in film, we are just the group insecure enough to feel defined by it.

We nurses are desperate to be understood but fall short of fixing the problem, so pick your head up, stop whining about long shifts, sore feet, and stunted emotions that come from the work you have chosen to do. Instead, find a way to share the pride you have in what you do.

There is so much more than these three lessons, but I think this is a good place to start. I learned a lot from a year of being Just a Nurse, I learned it all from you. So thank you, and keep up the good work.


A year ago today I posted to my hardly read blog about nursing. Apparently my feelings were universal as you, my readers, shared the post globally which to date has been read over a million times on this blog and even more by readers of the Huffington Post. In honor of this important milestone for my blog I have reposted a slightly edited version of the original post here. Tomorrow I will be back with my follow up of what I have learned in a year of being Just a Nurse.

In the first year of my career as a Registered Nurse I continued my education, wrapping up my Bachelor’s Degree in Nursing, not yet a requirement to work as an RN, but a well worth it continuation of a degree to make you a more well-rounded, and in my opinion, respected Nurse. One of the requirements for this degree was a course called “Professional Issues and Trends.” The course explored the profession of nursing, the barriers it is facing, and the way that we, as nurses, can change that. I learned many things in that course, but the most valuable lesson, the thing that has stuck with me the most was this.

A few days into the course, our Professor made one thing very clear; each and every one of us, from that moment on, needed to remove “Just a Nurse” from our vocabulary.

“Are you a Doctor?”

“No, I’m just a nurse.”

I have spent six years since trying to avoid that phrase. More so, I have worked to avoid that feeling. I work hard at what I do, but am often aware that my friends and family have no concept of what nursing really is. I don’t just bring you to your room at the doctor’s office, sit you on the table, and check your normal blood pressure, then go and get the Doctor. Instead, I am often in a room with a small child on a ventilator, multiple intravenous medications infusing through central lines keeping the vascular system constricted or dilated. I monitor blood gases and adjust ventilator settings accordingly. If the blood pressure goes too high I adjust the medications related to these values. I keep my patient adequately sedated and paralyzed, for their safety, without over medicating them. It is often my responsibility to determine this balance.

Recently, I had a nearly two year old patient who pulled his own breathing tube out in the early morning. We weren’t sure whether he would do ok without it so I monitored his respiratory status closely all morning. By mid-afternoon he seemed to be doing well enough. His sedation had worn off and he had no interest in spending another minute in bed. Concerned that he would harm himself moving around through multiple IV and arterial lines, plus a BiPap machine, and monitor leads, I decided to hold him. I was fortunate that day to only have the one patient since he still needed such close monitoring. He had no family present but needed close to a dozen IV medications over the next five hours. I collected them all and lined them on his bed. I pulled his syringe pump that would be used for the medications off of the IV pole and placed it on the bed in front of me. I lifted him out of bed and onto my lap, into my arms. For five hours we rocked and I held him close. He stared into my eyes, played with my hair with his one arm, tried to suck this thumb through IV sites and arm boards. I gave his medications one by one until the nurse who would relieve me for the oncoming shift came in.

I am not just a nurse. I am a nurse. Over the course of a 12 hour shift I can go from interpreting serial blood gases to comforting a sick child while continuing to monitor vital signs, respiratory status, and administer medications.

I am the eyes, hands, and feet of the physician. I am not their eye candy, or their inferior. I don’t stand up when they enter to room. I don’t follow their commands, we discuss the pathophysiology of the patient’s condition and together we make a plan. Often the things I suggest are the course of action we take, other times I learn something new I had not understood from this doctor. They don’t talk down to me, we discuss things together, as a team.

After a disagreement recently over a minor medical decision between myself and a doctor, a friend replied to me,

“No offense Kateri, but obviously we’re going with the doctor over the nurse for this one.”

“You’re just a nurse” they might as well have said, although I know that they did not.

I was surprised by how angry and affected I was. It felt as though the color left my face and the posture left my shoulders. Something inside of me sunk.

The following day I struggled to understand why I was still upset. Surely they had no idea what these words had meant to me, or how they felt. The intention had not been criticism or harm, I was making something out of nothing. Over lunch the following day, as I discussed my new job with my family, it became clear. My job is so much to me, and so much of it is misunderstood. And maybe this is no one’s fault but my own. Sure I’m a nurse… yup some days are sad… yeah, blood and poop don’t bother me. But that is all I say. I don’t tell you what I really do. And the media definitely doesn’t either.

Nurse friends, help me out here, maybe it’s time that we stop pretending we are less than we are, that we do less than we do.

I came across the following blurb this morning. I wrote it a few years ago for Nurse’s Day, and it rings as true today as it did then. I may not be a doctor, but I am a nurse. And if you are someone whose mind says “just a nurse” please, go ahead and ask the nurse you know best what it is that they do. I think you may be surprised.

I am a Nurse. I didn’t become a nurse because I couldn’t cut it in med school, or failed organic chemistry, but rather because I chose this. I work to maintain my patient’s dignity through intimate moments, difficult long term decisions, and heartbreaking situations. I share in the joy of newly born babies and miraculously cured diseases. I share in the heart break of a child taken too soon, a disease too powerful, a life changed forever. My patient is often an entire family. I assess and advocate. Sometimes I wipe bottoms, often I give meds, but that isn’t the extent of what I do. There are people above me, and people below. I work closely with both, without them, I could not do what I do well. I chose this profession and love almost every minute of it. I know I am not alone and I appreciate all of the nurses who work alongside me. Many of them have shaped me into the nurse I am. Someday I will shape others into the nurse they will be. This wasn’t my plan B, it was my plan A, and I would gladly choose it again.